John W Sperling

..Examine 90-day postoperative mortality and its predictors following shoulder arthroplasty..

..Among patients with an intact rotator cuff, TSA appears to be the preferred procedure for pain relief, improvement in abduction, and lower risk of revision surgery...

..The purpose of the present study was to determine the results, the risk factors for an unsatisfactory outcome, and the rates of failure of this procedure in patients fifty years of age and younger...

..Great care must be exercised, and alternative methods of treatment considered, before either hemiarthroplasty or total shoulder arthroplasty is offered to patients aged 50 years or younger...

..The data from this study suggest that Bankart repair in older patients is associated with a low recurrence rate, and similar results may be obtained with either open or arthroscopic procedures...

..The data from this study suggest that humeral windows may facilitate controlled removal of well-fixed humeral components with a high rate of union. Further evolution of this technique may result in a lower fracture rate...

..This information may be used to more accurately predict the need for transfusion and tailor preoperative blood ordering accordingly...

..There were no intraoperative complications, infections, or revisions. In this limited group of patients the results of shoulder arthroplasty after transplantation were satisfactory...

..We hypothesize that patients have a strong preference for arthroscopic shoulder surgery. Currently, there are no data in the literature reporting on how people perceive open versus arthroscopic shoulder surgery...

..The tear is then completed by "connecting the dots" outlined by the sutures and an arthroscopic repair is performed in the standard manner...

..Among those with recurrent posterior instability, it usually appears in the early postoperative period...

..Therefore, we reviewed the results of this procedure, the risk factors for an unsatisfactory outcome, and the rates of failure in our patients...

..There were four hemiarthroplasties and three total shoulder arthroplasties...

..The purpose of this study was to determine the prevalence of pulmonary embolism following shoulder arthroplasty...

..Loosening of the humeral component is rarely a cause for revision. This study was conducted to determine long-term survivorship of humeral components and investigate the risk factors associated with humeral component removal or revision...

..A recent ultrasound study has shown that impingement phenomenon was observed in healthy shoulders. We hypothesized that nonpathologic contact beneath the coracoacromial arch occurs in normal shoulders...

..The purpose of this study was to report on the incidence, treatment, and outcome of, as well as the risk factors for, intraoperative periprosthetic humeral fractures...

..For most, instability, rotator cuff tear, and glenoid wear occur together, and this is a challenging problem to treat successfully...

..Unconstrained shoulder arthroplasty is one of several methods for treatment of proximal humeral fracture nonunions. The goal of this study was to define the results and complications of this procedure...

..The purpose of this study was to determine the results, the risk factors for an unsatisfactory outcome, and the failure rates of total shoulder arthroplasty with a cemented metal-backed glenoid component...

..Several reports suggest total shoulder arthroplasty in patients with fractures has a relatively high rate of complications. Whether hemiarthroplasty reduces the rate of complications or improves pain or function is not known...

..However, recent studies have found that the defect is located anteriorly. The purposes of this study were (1) to clarify the critical size of the anterior defect and (2) to demonstrate the stabilizing mechanism of bone-grafting...

..6 years). Subsequent stem modifications included circumferential metaphyseal porous coating to enhance ingrowth and reduce loosening rates...

..Although posterior capsule tightness is believed to cause abnormal contact in the subacromial space, it is not clear whether this tightness changes the contact between the acromion and humeral head...

..We postulated that reconstruction with reverse shoulder prostheses would lead to early satisfactory results for these patients...

..The purpose of this study was to evaluate the effect of augmentation with dermal grafts on the biomechanical effects of rotator cuff repairs...

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..The advantage of this component seems marginal, and its use has been discontinued...

..Especially striking is the near absence of component revision because of loosening or other mechanical factors. Periprosthetic humeral fractures are more common; the explanation for this warrants further study...

..This study investigated the biomechanical strength of subscapularis tenotomy vs lesser tuberosity osteotomy in the setting of total shoulder arthroplasty...

..This information will assist the community surgeon in counseling patients and weighing the risks and benefits of a shoulder arthroplasty...

..This case highlights the importance of obtaining axillary views in shoulder trauma cases...

..Patient-administered methods should continue to be evaluated as a means of assessment of these patients...

..Although the relationship between posterior capsule and subacromial impingement has been recognized, this relationship during the baseball-pitching motion is unclear...

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..We proposed to radiographically and clinically investigate the outcomes of keeled and pegged glenoid components to test the hypothesis that these implants would have equivalent performance...

..However, there are a large number of unsatisfactory results related to glenoid cartilage wear over time...

..Functional gains should not be expected in patients with full-thickness rotator cuff tears. Repair of the rotator cuff in patients with rheumatoid arthritis can be undertaken when nonoperative measures for pain relief have failed...

..4 of 12 questions were answered affirmatively. This procedure is oncologically safe. There are structural complications, notably shoulder instability. Function ratings are one-third to one-half normal...

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..LEVEL OF EVIDENCE: Level IV, prognostic study. See Guidelines for Authors for a complete description of levels of evidence...

..However, arthroplasty in this setting is especially challenging because of the potential for significant bone and soft-tissue deficits. These challenges can compromise the clinical results...

..There is a slight clinical benefit to reimplanting a glenoid component whenever structurally possible. Positive cultures in revision surgery are common, with uncertain clinical significance...

..Experimental laboratory design...

..The decision as to whether this is the optimal surgical procedure for the treatment of osteoarthritis of the shoulder requires careful consideration...

..However, early postoperative instability appears to be higher in this patient population. The results of TSA in our patients with Parkinson's disease were marginal, with 20 (47%) achieving unsatisfactory results...

..The results from this study indicate a modest increase in stability when one chooses the larger of the 2 glenoid components...

..This study was conducted to determine the survival of different glenoid component designs, assess the reasons for revision surgery, and identify patient and diagnostic factors that influence this need...

..The purpose of this study was to determine the results, complications, and failure rates of shoulder arthroplasty in morbidly obese patients...

..Little information is available on CRP and ESR in patients undergoing revision or resection of shoulder arthroplasties or spine implants...

..While overall pain and motion can be expected to improve, unsatisfactory clinical results that are related to the destructive effects of the initial infection are not uncommon...

..This study was developed to examine the outcome of patients managed with a metal-backed, bone-ingrowth glenoid component as an alternative to a cemented component...

..More than one-half of the shoulders in the present study remained unstable despite attempts at revision. Surgical treatment of instability following arthroplasty is associated with only a modest success rate...

..If the component is well fixed, open reduction and internal fixation may be performed. If the component is loose, revision with a long-stem component is recommended. For type-C fractures, a trial of nonoperative treatment is recommended...

..The impingement mechanisms of the Neer and Hawkins sign remain unclear. In addition, there is still a lack of agreement regarding the arm rotation when performing the Neer sign...

..The purpose of this study was to define the results, complications, and frequency of revision surgery in this group...

..The deltoid muscle is in continuity with the distal arm fascia and musculature...

..Patients and treating physicians should be aware of the high rate of complications and unsatisfactory results in patients with rheumatoid arthritis who undergo operative treatment of proximal humeral fractures...

..Therefore, it is important for orthopaedic surgeons to be familiar with techniques to avoid complications and improve results when treating proximal humerus fractures...

..Results of distal clavicle resection with or without acromioplasty are favourable with a low rate of complications and seldom is further surgery required...

..Degenerative rotator cuff tears are increasing with the aging population, and healing is not uniform after surgery. Rotator cuffs may show improved healing when biologic factors are added during surgery...

..0535). The use of this procedure for correction of shoulder instability can prevent recurrent dislocation, but some degree of instability remains. Clinically important arthritis seldom develops...

..We therefore sought to determine the prevalence of pulmonary embolism after total elbow arthroplasty...

..Our data demonstrate deep infection is not an uncommon complication of distal biceps tendon repairs that initially can be treated without taking down the construct...

..An aging population and an increased demand and awareness by the public regarding interventions to improve quality of life will shape the future of arthroplasty, reinforcing the need for future studies of this nature...

..However, pain relief was less predictable with large or massive tears when compared with partial-thickness tears, and functional gains were not achieved in either group...

..5 years. The data from this study suggest that there are no good preoperative or intraoperative investigations to detect who will have a positive intraoperative culture at the time of revision shoulder arthroplasty...

..The purpose of this study was to determine the prevalence and risk factors associated with perioperative mortality after elbow arthroplasty...

..In this series only two patients with infected clavicles went on to bony union. The surgeon should be aware of the extreme difficulty in treating this complication and its poor prognosis...

..The frequency of revision surgery is increasing, as it is for hip and knee arthroplasty. The most common complications of shoulder arthroplasty can be avoided or successfully treated...

..Functional outcome is poor in those patients with irreparable rotator cuff tears and/or cartilage loss. LEVEL OF EVIDENCE: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence...

..There was no statistical difference in risk of transfusion by operative time. These data demonstrate that the rate of transfusion for total elbow arthroplasty varies by patient age and preoperative level of hemoglobin...

..Arthroscopic treatment or interposition arthroplasty may provide symptomatic relief without radically compromising future procedures...

..This study raises the question of whether prophylactic anticoagulation is needed after routine proximal humeral repair...

..Arthroplasty for proximal humerus nonunions and malunions has a guarded outcome because of limitations in shoulder motion, but pain relief is more consistently improved upon...

..This article offers a technique in which a large-bore cannula and high pressure and flow are used to facilitate the removal of loose bodies from the joint...

..Although function is not completely restored, pain relief and high levels of subjective satisfaction can be achieved...

..All shoulders with tuberosity nonunion or resorption had an unsatisfactory result...

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..In addition, the treating surgeon should be aware of the high incidence of Propionibacterium and the importance of allowing a minimum of 7 days of culture to identify this organism...

..LEVEL OF EVIDENCE: Level IV, therapeutic study, case series, no control group...

..Ninety-day mortality was closely associated with the underlying diagnosis. Perioperative mortality after shoulder arthroplasty for non-neoplastic conditions is low...

..However, additional advances are possible and may occur from improved surgical technique, decreased particle-related osteolysis, enhanced joint kinematics, or novel fixation methods...

..Identifying the center of the glenoid surface coupled with alignment of the glenoid prosthesis in neutral version and anatomic inclination provides a reliable means to guide placement of glenoid components...

..Treatment of idiopathic frozen shoulder by manipulation under anesthesia leads to sustained improvement in shoulder motion and function at a mean of 15 years after the procedure...

..In view of these results, current indications, surgical technique, and postoperative treatment may need to be revisited...

..They may be difficult to diagnose clinically and often require surgical repair. Magnetic resonance arthrography is superior to other imaging techniques, including conventional MRI, in the evaluation of shoulder instability...

..All efforts at fracture fragment fixation with osteosynthesis and hemiarthroplasty should be directed at obtaining anatomic fracture fixation that resists displacement...

..This brief review and the following articles in this supplement focus on persistent shoulder pain associated with rotator cuff disorders, adhesive capsulitis, and glenohumeral OA...

..In this study, patients with shoulder sepsis with rheumatoid arthritis were found to have a high rate of multiple joint sepsis and unsatisfactory shoulder function...

..Patients should be counseled that the results of treatment of deep infection are plagued with high complication rates, poor functional outcome, and a notably high nonunion rate...